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NPI Code Detail

MEDICARE: KATTY BURGOS

MEDICARE: KATTY BURGOS
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1373H00000XDay Training/Habilitation SpecialistCA

General Provider Information

NPI Number : 1891628541
Entity Type Code : Individual
Provider Name (Legal Business Name) : KATTY BURGOS
Provider Business Mailing Address
First Line : 225 W BROADWAY STE 155
Second Line :
City : GLENDALE
State : CA
Zip : 91204-1332
Country : US
Telephone Number : 310-818-2107
Fax Number :
Provider Business Practice Location Address
First Line : 225 W BROADWAY STE 155
Second Line :
City : GLENDALE
State : CA
Zip : 91204-1332
Country : US
Telephone Number : 310-818-2107
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/03/2026
Last Update Date : 06/03/2026

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Directions to “ KATTY BURGOS ” Practice Location

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